Person: GURBET, ALP
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GURBET
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ALP
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Publication Comparison of intra- and postoperative effectiveness of erector spinae plane block and patient controlled analgesia in patients undergoing coronary artery bypass grafting surgery(E-century Publishing Corp, 2022-01-01) Ogur, Lale; Akesen, Selcan; Goren, Suna; Kan, Irem Iris; Mogol, Elif Basagan; Gurbet, Alp; Akesen, Selcan; AKESEN, SELCAN; Goren, Suna; GÖREN, SUNA; Kan, Irem Iris; KAN, İREM İRİS; Mogol, Elif Basagan; MOĞOL, ELİF; Gurbet, Alp; GURBET, ALP; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Anestezi ve Reanimason Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kalp ve Damar Cerrahisihi Anabilim Dalı.; 0000-0002-6503-8232; A-7994-2018The aim of our study was to compare bilateral erector spinae plane block (ESPB) efficacy on pain management with patient controlled analgesia (PCA) during the perioperative period in patients scheduled for coronary artery bypass grafting (CABG). After ethics committee approval (2019-7/31 dated 09.04.2019) from the Bursa Uludag University Medical Trials Ethics Committee, (https://uludag.edu.tr/buuetikkurulu) ASA 50 patients aged between 18-80 years were included. They were randomly divided into two groups, ESPB (n=25) and control (n=25). In the preoperative period, bilateral ESPB with ultrasonography was applied to both groups with 0.25% bupivacaine (0.5 ml/kg) + dexamethasone (8 mg) or saline, respectively. PCA prepared with morphine was given to all patients postoperatively. Perioperative opioid use, extubation times, coughing/resting Visual Analog Scale (VAS) scores, duration for first PCA bolus dose requirement, rescue analgesia needs, mobilization times, and opioid side effects were evaluated. In the ESPB group, compared to the control group, intraoperative fentanyl consumption was lower (P=0.001). During the postoperative period; extubation time was shorter, the need for initial PCA was much later, morphine consumption and need for rescue analgesia was less (P=0.001; P<0.001; P<0.001; P=0.009, respectively). The postoperative VAS scores were lower for each measurement period (P<0.05). Opioid-related side effects were more common in the control group (P=0.040). First mobilization time in ESPB group was earlier (P<0.001). As a result, ESPB has a significant analgesic effect in CABG patients. It was concluded that bilateral ESPB reduces opioid requirement compared to intravenous morphine PCA alone and provides better pain management and more comfortable recovery.Publication Comparison of efficacy between the genicular nerve block and the popliteal artery and the capsule of the posterior knee (IPACK) block for total knee replacement surgery: A prospective randomized controlled study(Türkiye Ortopedi Travmatoloji, 2021-03-01) Akesen, Selcan; Akesen, Burak; Atıcı, Teoman; Gurbet, Alp; Ermutlu, Cenk; Özyalçın, Ali; AKESEN, SELCAN; AKESEN, BURAK; ATICI, TEOMAN; GURBET, ALP; ERMUTLU, CENK; ÖZYALÇIN, ALİ; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı; 0000-0002-3396-3407; 0000-0002-6503-8232; JHR-5447-2023; AEQ-5464-2022; ELR-9087-2022; AAH-9833-2021; A-5095-2018; A-7994-2018Objective: The aim of this study was to compare the efficacy of popliteal artery and the capsule of the posterior knee (IPACK) block and genicular nerve block on postoperative pain scores, the need for rescue analgesics, range of motion (ROM), walking distance, and perioperative monitorization variables in patients undergoing total knee replacement (TKR) surgery.Methods: Sixty American Society of Anesthesiologists (ASA) physical status I-III patients were enrolled in this study and then were randomly assigned into three groups: the IPACK block group (17 female, 3 male; mean age=67.5 +/- 1.4 years), genicular nerve block (16 female, 4 male; mean age=68 +/- 1.76 years), and the control group (13 female, 7 male; mean age=63 +/- 1.67years). All the patients underwent TKR under spinal anesthesia. The visual analog scale (VAS) score, mobility, pre- and intra-operative monitorization of systolic and diastolic holding area, non-invasive blood pressure, heart rate, and SPO 2 were compared between the groups.Results: Patients in the IPACK and genicular block groups had a significantly lower visual analogous scale (VAS) at postoperative 4 hours (p<0.01), 8h (p<0.01), 12h (p<0.01), and 24h (p<0.05). VAS score was significantly lower in the genicular block group at the postoperative 4h (5.5 +/- 0.55) and 8h (5.0 +/- 0.53) in the mobile state compared to the IPACK (8.0 +/- 0.47 and 8.0 +/- 0.43, respectively) and the control group (9.5 +/- 0.20; 10 +/- 0.28, respectively) (p<0.01). The use of patient-controlled-analgesia (PCA) devices and button push count for analgesics demand were significantly lower in the genicular block group on the immediate postoperative period (p<0.01 at the postoperative 0 to 4 h). The total consumption of morphine equivalents on the postoperative day 0 was significantly lower in the genicular block group (p<0.01, and p<0.001 for IPACK and control groups, respectively). The degree of flexion was significantly higher in the genicular block group at the postoperative 12h compared to the IPACK and the control group (p<0.001). The length of hospital stay was significantly lower in the genicular block group compared to the IPACK and the control group (p<0.05 for both variables).Conclusion: IPACK and genicular blocks both are effective in improving patient comfort during and after TKR surgery and reducing the potential need for systemic analgesic and opioids. The genicular block seems to be a promising technique that can offer improved pain management in the immediate and early postoperative period without adverse effects on systemic and motor variables.Publication The effect of combined pulsed radiofrequency treatment to dorsal root ganglion with transforaminal epidural steroid injection on pain(Kare Publ, 2021-01-10) Çalışkan, Duygu Karaköse; Akesen, Selcan; Türker, Yunus Gürkan; Gurbet, Alp; AKESEN, SELCAN; TÜRKER, YUNUS GÜRKAN; GURBET, ALP; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı.; 0000-0002-3019-581X; 0000-0002-6503-8232; 0000-0002-9518-541X; AAI-6642-2021; A-7994-2018; ELR-9087-2022Objectives: We aimed to compare the treatment response with simultaneous application of transforaminal epidural steroid injection (TESI) and pulsed radiofrequency (PRF) to the lumbar dorsal root ganglion (DRG) with TESI in patients with chronic lumbar radicular pain.Methods: A total of 129 patients were enrolled. TESI was performed to 67 patients and TESI+DRG-PRF was performed to 62 patients. Demographic data, surgical records, and medications, side, and level of the procedure were recorded. Patients were evaluated on the pre-operative and post-operative 10th day, 1st and 3rd month follow-up visits, and visual analog scale (VAS, 0-10) scores, and patients' satisfaction assessment on the 3rd month follow-up were collected. A successful therapeutic response was defined as a 50% or more reduction in VAS scores.Results: In both groups, post-operative VAS scores were significantly lower than the pre-operative levels (p<0.001). VAS scores in the TESI+DRG-PRF group were significantly lower than the TESI group at all follow-up periods (p<0.001). Reduction ratios in VAS scores were significantly higher in the TESI+DRG-PRF group in all follow-up visits (p<-0.001). Satisfaction levels were significantly higher in the TESI+DRG-PRF group (p<0.01).Conclusion: According to our study, TESI provides short-moderate pain relief in patients with chronic lumbar radicular pain. A simultaneous application of PRF in the same session with TESI should be considered as an option to improve the treatment response.Publication Preemptive analgesic effects of intravenous paracetamol in total abdominal hysterectomy(Kare Publ, 2009-04-01) Arıcı, Semih; Gurbet, Alp; Türker, Gürkan; Yavaşcaoğlu, Belgin; Şahin, Şükran; Arıcı, Semih; GURBET, ALP; TÜRKER, YUNUS GÜRKAN; YAVAŞCAOĞLU, BELGİN; Şahin, Şükran; Uludağ Üniversitesi/Tıp Fakültesi/Anestezi ve Reanimasyon Anabilim Dalı.; 0000-0002-6503-8232; 0000-0002-3019-581X; 0000-0003-4820-2288; A-7994-2018; AAI-7914-2021; JZE-5924-2024; AAI-6642-2021; AAG-9356-2021Objectives: Paracetamol is primarily thought to be a cyclooxygenase inhibitor acting through the central nervous system. Indirect effects of paracetamol are through the serotoninergic system as a non-opioid analgesic. In this study, total abdominal hysterectomy patients were given intravenous (iv) paracetamol 1 g preoperatively or intraoperatively to assess its postoperative analgesic effects.Methods: 90 patients undergoing total abdominal hysterectomy were enrolled into the study. Patients were randomized into three groups: in Group I, iv paracetamol 1 g was given 30 minutes prior to induction. In Group II, iv paracetamol 1 g was given prior to skin closure. Group III served as the control group and received saline as placebo. Postoperatively, all patients received morphine via patient-controlled analgesia pump. Postoperatively, rest and activity pain scores, sedation scores, hemodynamic parameters, postoperative morphine consumption, side effects, patient satisfaction, and total hospital stay were recorded.Results: In the control group, at rest and movement pain scores and total morphine consumption via patient-controlled analgesia were higher than in Groups I and II. When Groups I and II were compared, total morphine consumption was much greater in Group II. Intravenous paracetamol intraoperatively and postoperatively did not result in any hemodynamic effects.Conclusion: In total abdominal hysterectomy, preemptive iv paracetamol 1 g provided good quality postoperative analgesia, with decreased consumption of morphine and minimal side effects.